Objective To investigate the situation of infectious diseases prevention and control and its possible influencing factors of primary and middle schools in Pudong New Area,in order to provide evidence for establishment of effective control system of primary and middle schools.Methods The situation of infectious diseases prevention and control of 368 primary and middle schools in Pudong New Area was investigated.Results Organization and relevant system for infectious diseases prevention and control were carried well,but the proportion of full-time health care personnel was low.There had been infectious diseases in 297 (80.71％) schools from 2013 to 2015,involving 4 326 cases.And 129 (35.05％) schools had 255 infectious diseases clusters.Whether the disinfection of sanitary ware and indoor air were qualified were the possible influencing factors of infectious diseases prevention and control.Conclusions The overall work of infectious diseases prevention and control is developed well,but some aspects need further improvement.

Objective To establish emergency disposal procedures of healthcare-associated infection(HAI) in Pudong New Area, evaluate on-site investigation method, identify the key links and risk factors for infection, and timely control HAI outbreak.Methods From January 2012 to December 2014, epidemiological investigation on HAI outbreaks in 65 hospitals in Pudong New Area was performed, emergency plan for disposal procedures of HAI was initiated, the emergency disposal procedures of each event was evaluated by experts.Results There were 6 infection outbreaks occurred in Pudong New Area from January 2012 to December 2014, all were HAI, and no community-associated infection existed simultaneously;6 cases of HAI outbreaks involved 119 persons, the major were hospitalized patients (n=99,83.19%) and care workers (n=16,13.45%);5 outbreaks all detected Norovirus, the main transmission route wasclose contact of nurses with patients during care for patients;the evaluation of each incident revealed that the total score was >90.Conclusion The emergency disposal procedure of HAI suitable for Pudong New Area has been established, the effect is good and proved effective according to the expert evaluation on practical outbreaks.

Objective:To explore the method of the establishment of edentulous mandible All-on-4 implant photoelastic model with various distally tilted implants by computer-aided design(CAD).Methods:The edentulous mandible specimen was scanned by CT. Three-dimensional models of the mandible consisting of implant location were reconstructed and edited with Mimics and Geomagic Stu-dio software.Each of the four models had four implant sockets in the interforaminal area.In the first model,the bilateral distal im-plants were placed vertically.In the other models,the posterior implants were respectively inclined by 1 5°,30°and 45°distally.The four models were manufactured by RP and then the All-on-4 photoelastic models were made by traditional ways.Results:The ob-tained ethoxyline resin models featured bright surface,homogeneous structure,faintly yellowish,high optical sensibility,precision im-plants location and with no natural stress.The model offered a good experimental basis for the stress measurement.Conclusion:The method of fabricating ethoxyline resin models by CAD is reproducible,which simplifies the operating process.

Objective To investigate the prevalence of healthcare-associated infection(HAI)in medical institutions in Pudong New Area.Methods Ten medical institutions in Pudong New Area were selected as monitored hospitals, cross-sectional survey on HAI in each hospital at a given day of November 2013 and November 2014 were conduc-ted.Prevalence of HAI in different levels of hospitals were compared.Results The prevalence rates of HAI in 2013 and 2014 were 4.04% and 3.75% respectively,there was no significant difference between two years(χ2 =0.709,P=0.400).The prevalence rates of HAI in primary,secondary,and tertiary hospitals in 2013 were 0.66%,3.32%, and 4.60% respectively,in 2014 were 0,3.52%,and 4.01 % respectively,prevalence rates of HAI in different lev-els of hospitals of each year were significantly different (all P <0.05).Prevalence rates of HAI were high in depart-ments of neurosurgery,hematology,intensive care units(ICUs),and gerontology.The prevalence rate of infection in ICUs increased obviously,from 10.09% to 18.78% (χ2 =3.921 ,P =0.048),departments of gerontology de-creased obviously,from 10.07% to 5.02%(χ2 =5.698,P =0.017).The main HAI sites were lower respiratory tract (36.72%),upper respiratory tract (9.96%),and urinary tract (12.89%).172 pathogenic isolates were de-tected in 2013,and 177 were detected in 2014,gram-negative bacteria,gram-positive bacteria,and fungi accounted for 60.74%,26.37%,and 12.89% respectively.Constituent ratios of pathogens causing HAI between two surveys were not significantly different (χ2 =5.819,P =0.830).Conclusion Among different levels of hospitals in Pudong New Area,tertiary hospitals have the highest prevalence rate,HAI in ICU increases obviously,the main HAI site is lower respiratory tract,the main pathogens are gram-negative bacteria.

Objective To observe and compare the effects of extracorporeal shock wave therapy(ESWT) and that of joint mobilization technique on periarthritis of shoulder. Methods Eighty-two patients were divided into two groups randomly, a treatment group (n=42) treated with extracorporeal shock wave therapy, and a control group (n=40) treated with joint mobilization technique. All the patients were evaluated with Visual Analogue Scale (VAS) and Constant-Murley Scale(C-M scale) before and half a month after the treatment. Results After treatment the results obtained with the use of VAS Scale and C-M Scale (only ADL and ROM) were significantly different in two groups when compared with those before the treatment (P

Objective To evaluate the clinical significance of chronic hepatitis B (CHB) with concurrent hepatitis e antigen (HBeAg) and antibody (anti-HBe) during antiviral therapy. Methods A total of 115 CHB patients with concurrent HBeAg and anti-Hbe detection during antiviral therapy were enrolled in this retrospective study. All patients received pegylated-IFN-alpha-2a (Peg-IFNα-2a, n = 50) or entecavir (ETV, n = 65) for antiviral treatment. Their biochemical virological and serological response and clinical outcome were detected and analyzed. Results Among the patients treated with Peg-IFNα-2a, 31 (62.0%) achieved HBeAg seroconversion and 6 (12.0%) achieved HBsAg seroconversion at the end of treatment. About 35.4% of patients, who received ETV, achieved HBeAg seroconversion and none of them achieved HBsAg seroconversion at the end of treatment (P < 0.05). Conclusion High rates of HBeAg seroconversion and HBsAg loss could be achieved in CHB patients, with co-existence of HBeAg and anti-HBe, who received Peg-IFNα-2a, but not ETV therapy.

Objective To evaluate the clinical value of preoperative mark with methylene blue for the submucosal tumor originating from the muscluaris propria around the cardia in submucosal tunnel.Meth-ods A total of 27 patients with cardiac tumors originating from muscularis propria diagnosed by endoscopy and endoscopic ultrasonography underwent endoscopic submucosal tunnel dissection from June 2011 to May 2014.Eighteen cases were marked by methylene blue,and 9 others were not.The operation time and the in-cidence of complications were compared between the two groups.Results All lesions were resected success-fully.The time of lesion location of non-mark group was 14.7 minutes(9-32 min),and that of mark group was 8.1 minutes(7-10 min).The incidence of subcutaneous emphysema of thorax and cervix of non-mark group was 2 /9(2 cases),and that of the mark group was 1 /18(1 case).The incidence of pneumoperitone-um of non-mark group was 1 /9(1 case),while that of the mark group was 2 /18(2 cases).There was no pneumothorax or mediastinal emphesema in all cases.Conclusion Marking with methylene blue before op-eration can shorten operation time effectively and lower incidence of complications.

Objective To investigate the effect of hyperthermia on the expression of E6 and E7 genes of human papillomavirus (HPV) type 6 and 11 in HPV-infected human skin. Methods Tissue samples were obtained from the lesions of condyloma accuminatum (CA) in 6 patients after informed consent. Each sample was divided into 4 parts: one was embedded and directly stored at -80 ℃; the other 3 parts were placed in culture medium and the surface of the samples was irradiated for 30 minutes with a thermotherapy apparatus at 37℃, 42 ℃, 45 ℃, respectively, then the samples were taken out and stored at -80 ℃. RNA was extracted from the specimens, real time quantitative PCR (qPCR) was performed to detect the expression of E6 and E7 genes of HPV-6 and -11. Results Of the 6 patients, 2 were infected with HPV-6 and -11 respectively, 4 with both HPV-6 and HPV-11. The expression of E6 and E7 mRNA decreased with the increase in irradiation temperature. The relative mRNA expression levels at 37 ℃, 42 ℃ and 45 ℃ were 1.00 ± 0.00, 0.61 ± 0.17, 0.27 ± 0.15, respectively, for HPV-6 E6 gene, 1.00 ± 0.00, 0.56 ± 0.21, 0.16 ± 0.11 respectively, for HPV-6 E7 gene, 1.00 ± 0.00, 0.60 ± 0.22, 0.16 ± 0.08, respectively, for HPV-I1 E6 gene, 1.00 ± 0.00, 0.55 ± 0.15, 0.24 ± 0.06, respectively, for HPV-11 E7 gene; statistical difference was noted among them between the specimens irradiated at different temperature (all P < 0.01). Conclusion Hyperthermia can remarkably suppress the expression of HPV-6/I 1 E6 and E7 genes, which may be a possible mechanism under the regression of warts induced by local hyperthermia.

U1 trastuctrural changes of myocardium and lungs from 6 cases died of cranioce-rebral penerating gunshot wound 2 hours after injury is reportcd.In all cases theelectron microscopy of the myocardial and lung tissue samples showed the similar ultrastructural morphological changes of the cells and interstitial tissues.The mostpr-ominent ultrastructural changes of myocardium were disorderly arrangement of the Zband.focal dissociation of the myofibrills,mitochondrial swelling with decreasing ofmatrix density and disruption of cristae,and interstial edema.The changes of theung tissue were increasing of width of alveolar septa with decreasing of the electron density.Aggregation of neutrophils in the capillaries of alveolar septa and some alveolar space was observed.The significance and the pathogenesis of the mainpathological changes were discussed.It is suggested that the pulmonary interstitialedema was neurogenic.The pulmonary edema may be manifested as interstitial edemaor intra-lveolar edema depending upon the time elapsed after the gunshot injury.